Malignant transformation of hepatic endometriosis: a case report and literature review

Dandan Wang, Qing Yang, Huaitao Wang, Chang Liu
BMC women's health · 2021 · vol. 21(1) , pp. 249 · doi:10.1186/s12905-021-01366-6 · PMID:34154577 · W3173246049
review OA: gold CC0 ⤵ 6 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This case report and literature review describe a rare instance of endometrioid adenocarcinoma in the liver originating from hepatic endometriosis in a 50-year-old woman, highlighting diagnostic challenges and management considerations.

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Abstract

BACKGROUND: Extrapelvic endometriosis is defined as the presence of ectopic endometrial tissue in structures outside the pelvis. Although extra-pelvic endometriosis is generally considered benign conditions, malignant potential within endometriotic foci occurs even after definitive surgery. Malignant transformation of hepatic endometriosis is extremely rare. Preoperative diagnosis of this cancer is difficult, and no guidelines on the optimal management currently exist. Here, we present a case report of malignant transformation of hepatic endometriosis and a brief literature review to highlight the current knowledge of the prevalence, clinical features, diagnosis, and management of this condition. CASE PRESENTATION: A 50-year-old woman with a 2-year duration of progressive right upper quadrant abdominal pain was admitted to the hospital. She underwent hysterectomy and bilateral salpingo-oophorectomy for benign conditions 4 years prior. Tumor markers demonstrated elevated carbohydrate antigen (CA)-199 112U/mL (normal range: 0-35U/mL) only. Radiological imaging suggested the presence of a 10.7 × 7.7-cm mass in the right lobe of the liver extending to the diaphragm. The intraoperative frozen sections suggested malignant tumor. Right hepatectomy with infiltrating diaphragm resection was performed. The final pathology with immunohistochemistry staining confirmed endometrioid adenocarcinoma in the liver originating from preexisting hepatic endometriosis. After the multidisciplinary team meeting, the consensus was surgery followed by adjuvant chemotherapy. To our knowledge, this is the first case of Chinese woman of a malignant liver tumor originating from endometriosis ever reported by reviewing the current English medical literature. CONCLUSION: Though rare, extrapelvic endometriosis-associated cancers should be considered as differentiated diagnosis even after hysterectomy and bilateral salpingo-oophorectomy. This case highlights the importance of collaborative efforts across multiple disciplines for accurate diagnosis and appropriate treatment of malignant transformation of hepatic endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Carcinoma, Endometrioid Carcinoma, Endometrioid Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Hysterectomy Liver Middle Aged Salpingo-oophorectomy

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References (23)

Cited by (6)

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